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NPI 1346220290

NPI 1346220290 : LISA M WEST M.D : MIDLOTHIAN, VA

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General NPI Number Information
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    NPI Number           |    1346220290
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    Entity Type          |    Individual 
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    Provider Name        |    LISA M WEST M.D
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/18/2006
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    Last Update Date     |    12/26/2014
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Provider Practice Location Address
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    Address Line         |    3738 WINTERFIELD RD SUITE 100
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    City                 |    MIDLOTHIAN
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    State                |    VA
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    Zip                  |    23113-9236
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    Country              |    US
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    Telephone            |    804-378-9378
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    Fax                  |    804-378-9379
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Provider Business Mailing Address
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    Address Line         |    3738 WINTERFIELD RD SUITE 100
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    City                 |    MIDLOTHIAN
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    State                |    VA
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    Zip                  |    23113-9236
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    Country              |    US
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    Telephone            |    804-378-9378
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    Fax                  |    804-378-9379
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207VG0400X
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    Taxonomy Name        |    Gynecology Physician
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    License Number       |    0101053220
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    License Number State |    VA
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